Tuberville, Moran Introduce Bipartisan Legislation to Strengthen Rural Hospitals

August 4, 2026 - WASHINGTON, D.C. - U.S. Senator Tommy Tuberville (R‑AL) and U.S. Senator Jerry Moran (R‑KS) have introduced new bipartisan legislation aimed at bolstering rural hospitals and expanding access to federal support for facilities at risk of closure. The Rural Emergency Hospital Designation Improvement Act (REH 2.0) seeks to strengthen the Rural Emergency Hospital (REH) Medicare designation and ensure more rural communities can maintain essential health care services.

The bill would broaden eligibility for the REH designation, allowing additional Critical Access Hospitals (CAHs) and vulnerable rural hospitals to access federal resources designed to stabilize operations and preserve emergency care in underserved areas.

Tuberville: Rural Hospitals Are a Lifeline in Alabama

Senator Tuberville emphasized the importance of rural health care in Alabama, where 55 of the state's 67 counties are classified as rural.

"Our rural hospitals provide a lifeline to Alabamians who live further away from larger medical facilities," Tuberville said. "I'm proud to join the REH Designation Improvement Act to ensure location doesn't prevent Alabamians from being able to access quality care in times of emergency."

Moran: Legislation Built on Direct Feedback From Rural Providers

Senator Moran noted that the bill reflects years of conversations with rural hospital leaders across Kansas.

"Providers shared with me their recommendations for strengthening the Rural Emergency Hospital designation so it can better support the struggling facilities it was originally intended to serve," Moran said. "This legislation is the direct result of what we have heard from rural hospitals and health care providers in our states."

Moran also credited Senator Tina Smith (D‑MN) for her role in shaping the bill's provisions.

Broad Bipartisan Support

The REH 2.0 Act is cosponsored by Senators Katie Britt (R‑AL), Shelley Moore Capito (R‑WV), Cindy Hyde‑Smith (R‑MS), Roger Marshall (R‑KS), and Tina Smith (D‑MN). The National Rural Health Association has formally endorsed the legislation.

Key Provisions of the REH 2.0 Act

The bill includes several major updates intended to expand eligibility, improve flexibility, and strengthen financial support for rural hospitals:

Reopening Pathway: Allows previously closed rural hospitals to reopen and apply for REH designation if they met eligibility requirements between January 1, 2015, and December 27, 2020.

Waiver Program: Directs the Department of Health and Human Services (HHS) to create a waiver pathway for facilities operating similarly to an REH to convert formally.

Expanded Care Options: Permits REH facilities to maintain or establish units for inpatient psychiatric care, obstetric services, and limited inpatient rehabilitation.

Laboratory Funding: Requires CMS to provide additional reimbursement for laboratory services.

Grant Eligibility: Clarifies that REH facilities qualify for Small Rural Hospital Improvement Program grants.

NHSC Site Status: Allows REHs to be designated as National Health Service Corps sites, improving recruitment of medical professionals.

Skilled Nursing Transfers: Authorizes REHs to transfer patients internally from acute care to Skilled Nursing Facility care under existing Social Security Act provisions.

Return to CAH Status: Enables REHs to revert back to Critical Access Hospital status if they previously held "necessary provider" designation.

Medicaid Clarification: Confirms that state Medicaid agencies may reimburse REHs as hospitals.

A Push to Stabilize Rural Health Care Nationwide

The REH 2.0 Act represents a significant bipartisan effort to address the ongoing challenges facing rural hospitals, many of which have struggled with declining patient volumes, workforce shortages, and financial instability. Supporters say the legislation will help ensure rural communities continue to have access to emergency care, specialty services, and sustainable hospital operations.